Provider Demographics
NPI:1306267778
Name:TUDOR HEIGHTS
Entity type:Organization
Organization Name:TUDOR HEIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:F
Authorized Official - Last Name:LAPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-318-8000
Mailing Address - Street 1:7218 PARK HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5474
Mailing Address - Country:US
Mailing Address - Phone:410-318-8000
Mailing Address - Fax:410-358-7024
Practice Address - Street 1:7218 PARK HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-5474
Practice Address - Country:US
Practice Address - Phone:410-318-8000
Practice Address - Fax:410-358-7024
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SENIOR LIFESTYLE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-02
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30AL3197311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)